Back and Neck Pain
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Common Types of Back and Neck Pain
Back and neck pain can occur in many forms. Some types of pain are more serious than others, so it’s important to seek an evaluation and care from an expert.
Injuries often heal within days or weeks and are referred to as acute. Those injuries lasting longer than three months are considered chronic. In both cases, addressing the condition sooner often leads to better outcomes, and a return to quality of life.
The most common types of back and neck pain are often due to muscle or soft tissue injury. Lumbar (back) or cervical (neck) strain can occur after any event that stresses the tissues and can range in severity. This soft-tissue injury can occur due to trauma, improper use, or overuse.
Treatment options include over the counter medications, muscle relaxants, topical creams, physical therapy, muscle injections, TENS units, and laser treatment.
Weill Cornell Medicine’s Pain Management is unique in offering all these therapies including in-office laser treatment.
Herniated discs are often referred to as slipped or ruptured discs and can often be described as a pinched nerve or sciatica. The condition results from a tear in the outer layer of a disc (the cushion between the vertebral bones in the spine). It can happen in any part of the spine but is most common in the lumbar (lower back) or cervical (neck) regions of the spine. Herniated discs can happen to people of all ages, including children, and affect both men and women.
Herniated Disc Symptoms
The symptoms of a slipped disc vary from person to person, depending on the size and location of the herniation, weight, fitness level, and other factors. The most common symptoms include:
- Intermittent or continuous back pain (this may be made worse by movement, coughing, sneezing, or standing for long periods of time)
- Muscle spasms
More concerning symptoms include:
- Pain that starts near the back or buttock and radiates down the leg to the calf or into the foot (this is from “sciatica,” meaning pressure on the large sciatic nerve in the lower back, buttocks, and legs) or similarly, neck radiating to the arm(s)
- Numbness in the leg or foot
- Decreased reflexes at the knee or ankle
If you develop the following, seek care more urgently:
- Muscle weakness in the legs or arms
- Change in bowel or bladder control
- Difficulty moving your arm or leg due to weakness
Treatment Options for Herniated Disc
Once a diagnosis is confirmed, an individual with a herniated disc should be referred to a major spine center for a full evaluation and individualized treatment plan.
Treatments for ruptured discs vary, depending on the location and severity of damage. Treatment options are usually conservative at first, and can include:
- Physical and occupational therapy
- Over-the-counter pain medications including anti-inflammatories
- Oral steroids
- Muscle relaxants
- Injection steroid therapy
In most cases, the symptoms will resolve within four to six weeks. Your doctor can help you manage the symptoms during that time.
Weill Cornell Medicine’s Pain Management team will help design your physical therapy program and make the connection with our network of physical therapists in your area.
If these initial treatments are ineffective, other options will be considered. The spine team at the Weill Cornell Medicine Center for Comprehensive Spine Care believes in an interdisciplinary approach to the treatment of ruptured discs, including pain management and physical therapy. Minimally invasive surgery is considered only when necessary, in collaboration with our spine surgeons.
Spondylolisthesis refers to the forward or backward displacement of a bone in the vertebral column, leading to misalignment of the vertebrae in the spine. It is not the same as a herniated disc, although the two can coexist.
Isthmic spondylolisthesis is the most common form, which occurs with a slip or fracture of the intervertebral discs. When spondylolisthesis occurs in children or teens, it is usually due to a birth defect or a traumatic injury. (In fact, spondylolisthesis is the most common cause of back pain in teens.) In adults, the most common cause of spondylolisthesis is natural wear and tear due to aging and arthritis.
Symptoms of Spondylolisthesis
Symptoms of spondylolisthesis range in severity, depending on the location and cause of the slippage. Some people may have no pain at all or have only mild back pain. However, as the condition worsens, symptoms may include:
- Low-back pain, ranging from mild to severe
- Changes in posture and gait
- Hamstring muscle tightness or spasms
- Buttock pain, numbness, or tingling
- Back stiffness
- Weakness or tingling in the legs and feet
- Tenderness around the area of the slipped disc
Non-surgical treatment options for spondylolisthesis include:
- Physical therapy
- Thermal treatment
- Lumbar traction
- Electrical stimulation
- Medications, such as nonsteroidal anti-inflammatory medicines, combined with acetaminophen, or corticosteroids
- Epidural steroid injections
- Lumbosacral orthotic device
Finally, when surgery is not an option, neuromodulation can be a worthwhile option.
Spinal stenosis is a condition in which open spaces within the spine become narrowed, causing pressure on the spinal cord and nerves of the spine. It can be a natural result of aging, as the spinal canal becomes compressed through years of wear and tear. In other cases, spinal stenosis can be attributed to a specific cause such as an injury, accident, or a related spine condition such as a herniated disc.
Spinal Stenosis Symptoms
When pressure is placed on the spinal cord, it may result in swelling of the cord. Symptoms may come on either suddenly or gradually and may include:
- Difficulty walking or standing, but pain improves when sitting down
- Balance problems
- Dropping items
- Difficulty with fine motor skills, such as buttoning, handwriting, or picking up small objects
- Arm or leg weakness, cramping
- Changes in bladder or bowel function
Treatment Options for Spinal Stenosis
The first course of treatment includes exercises to improve flexibility, as well as anti-inflammatory and neuropathic medications to help relieve pain.
Other treatments include:
- Epidural injections
- Spinal cord stimulation
- Intrathecal delivery of medication
- Minimally invasive procedures to treat stenosis
The physicians at Weill Cornell Medicine’s Division of Pain Management lead the area in offering new technologies, such as state-of-the-art spinal cord stimulators, and are the only hospital in the area to provide minimally-invasive spinal procedures, including Vertiflex and MILD for spinal stenosis.
Neck and back pain can occur due to arthritis and degeneration of the facet joints, sacroiliac joint, or vertebral bodies. Increased risk factors for injury include contact sports, horseback riding, weightlifting, motor vehicle collisions, and wear and tear with age and activity. Genetics and being overweight can lead to these conditions as well.
Neck Arthritis Symptoms
- Pain in the neck or between the shoulder blades that can be dull or sharp
- Difficulty turning your head
Back Arthritis Symptoms
- Pain in the back, buttock, or thighs
- Difficulty bending backwards or forwards
- Difficulty standing or sitting for prolonged periods
Treatment Options for Arthritis Pain
There are multiple non-surgical measures that you can take to obtain relief of pain. Application of heat or cold, traction, physical therapy including ultrasound, massage, and manipulation may all improve your symptoms, and help strengthen the muscles in the neck.
Other treatments include:
- Local injections of steroids
- Analgesics, including nonsteroidal anti-inflammatory drugs or topical anesthetic creams
- Radiofrequency ablation of the nerves to quiet the nerves that feel pain in these joints
Why Choose Weill Cornell Medicine for Back and Neck Pain?
The Center for Comprehensive Spine Care in New York City consists of specialists in neurology, pain management, neurosurgery, psychiatry, radiology, and psychology. The multidisciplinary team provides personalized and precise care and treatment options for all types of back and neck pain.
In addition to state of art care, cutting edge research, and teaching opportunities, it is the coordinated care at the Center for Comprehensive Spine Care that sets us apart from other centers. Every Wednesday, the whole team comes together to discuss challenging cases and provide additional input, opinions, and teaching. It’s like having ten different set of eyes on each patient.
The physicians at Weill Cornell Medicine Division of Pain Management use the latest research, the most advanced equipment, and innovative therapies to diagnose pain and develop a customized pain management plan for each patient. We work closely with a broad team of specialists to provide the highest quality care, often in our spa-like, office-based setting.
We lead the area in offering new technologies, such as state-of-the-art spinal cord stimulators and minimally-invasive spinal procedures, including Vertiflex and MILD for spinal stenosis.
Finally, we offer the latest options in medication therapy, including low-dose naltrexone, medical marijuana, and a complement of topical treatments.
Weill Cornell Medicine also offers clinical trials, giving patients access to treatments that may not be available elsewhere. Learn more about Pain Management's current clinical trials.